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www.micropathology.com [email protected] Micropathology Ltd Tel 24hrs: +44 (0) 24 - 76 – 323222 Fax / Ans: +44 (0) 24 - 76 - 323333 University of Warwick Science Park, Venture Centre, Sir William Lyons Road, Coventry CV4 7EZ Website: www.micropathology.com E-mail: [email protected] The Interpretation of Diagnostic Blood tests for Hepatitis E Virus (HEV) HEV Ab IgG - Hepatitis E antibody – IgG anti-HEV • DETECTED in both acute cases and in those previously exposed • The length of time the antibody can be DETECTED may vary depending on assay specificity and sensitivity and the duration of continued exposure to the virus • Has been DETECTED for at least 12 years after acute infection • A protective level of antibody has not yet been established and protection may not be lifelong HEV Ab IgM – IgM anti-HEV • Used to confirm the diagnosis of acute HEV • Usually DETECTABLE at the onset of symptoms or abnormal liver function. This may be 2 to 9 weeks after exposure • May be UNDETECTABLE in acute cases and false positives can occur • Duration of DETECTION varies between patients and on assay used • Strongly positive results are rarely DETECTED 3 months after the onset of symptoms HEV RNA - Hepatitis E Virus RNA • Presence in blood indicates infectivity and active viral replication • Can be DETECTED in blood immediately prior to the onset of symptoms • Becomes UNDETECTABLE within a few days to weeks after the onset of symptoms • HEV RNA testing may help to elucidate acute hepatitis cases of unknown etiology • Test available only in specialist centres HEV genotype and subtypes • Hepatitis E has four major genotypes (1, 2, 3 and 4) but all can be considered to belong to one serotype Copyright Micropathology Ltd Page 1 of 2 Note: • • • • Diagnosis of an acute case rests on detectable IgM anti-HEV and rising levels of IgG anti-HEV or detection of HEV RNA in blood or stool Chronic HEV has been documented in patients receiving immunosuppressive therapy following organ transplantation A number of HEV vaccines are under development Pregnant women, especially those in the third trimester suffer an elevated mortality rate ~25% Copyright Micropathology Ltd Page 2 of 2